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    DR Ketut - Interventional Pain Management

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    Freade Akbar
    Chronic pain is defined as pain persisting beyond normal tissue healing time, which is assumed to be three to six months. Interventional pain management techniques can help treat both acute and chronic pain conditions in a minimally invasive manner. These techniques include injections, nerve blocks, radiofrequency ablation, and various spinal procedures to help reduce pain and avoid the need for surgery. The overall goal is to help patients achieve freedom from pain.

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    DR Ketut - Interventional Pain Management

    Uploaded by

    Freade Akbar
    112 views36 pages
    Chronic pain is defined as pain persisting beyond normal tissue healing time, which is assumed to be three to six months. Interventional pain management techniques can help treat both acute and chronic pain conditions in a minimally invasive manner. These techniques include injections, nerve blocks, radiofrequency ablation, and various spinal procedures to help reduce pain and avoid the need for surgery. The overall goal is to help patients achieve freedom from pain.

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    Intervensi Nyeri

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    6. Dr Ketut --Interventional Pain Management

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    Chronic pain is defined as pain persisting beyond normal tissue healing time, which is assumed to be three to six months. Interventional pain management techniques can help treat both acute and chronic pain conditions in a minimally invasive manner. These techniques include injections, nerve blocks, radiofrequency ablation, and various spinal procedures to help reduce pain and avoid the need for surgery. The overall goal is to help patients achieve freedom from pain.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    112 views36 pages

    DR Ketut - Interventional Pain Management

    Uploaded by

    Freade Akbar
    Chronic pain is defined as pain persisting beyond normal tissue healing time, which is assumed to be three to six months. Interventional pain management techniques can help treat both acute and chronic pain conditions in a minimally invasive manner. These techniques include injections, nerve blocks, radiofrequency ablation, and various spinal procedures to help reduce pain and avoid the need for surgery. The overall goal is to help patients achieve freedom from pain.

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    of 36

    INTERVENTIONAL PAIN MANAGEMENT

    KETUT NGURAH GUNAPRIYA dr SpAn KIC FIPM FIPP CIPS


    MAYAPADA HOSPITAL
    ACUTE PAIN IS ALARM
    Definisi Nyeri

     MENURUT IASP 1979 “ PAIN IS DEFINE AS: AN UNPLEASANT


    SENSORY AND EMOTIONAL EXPERIENCE ASSOCIATED WITH ACTUAL
    Makna dari definisi
    OR POTENTIAL TISSUE ini adalah:
    adalah
    DAMAGE : DESCRIBE IN TERM OF SUCH
    OR

    DAMAGE . (Hof
    Key word AROLD MERSKEY )
    pain is unpleasant
    unpleasant sensory and emotional
    experience (rasa yg tdk menyenangkan sensorik dan emotional
    emotional)).
     Associated with actual tissue damage (Acute
    (Acute Pain =Nociceptive
    pain)
     Due to potential
    potential tissue damage (Nociceptive pain = Physiological pain =
    withdrawal Reflex)
     Described in term of such damage (digambarkan seperti adanya
    kerusakan jaringan .(
    .(tapi tidak))  chronic pain .
    tapi tidak
    1. Nociceptive Pain
    • NYERI NOSISEPTIF ADALAH NYERI
    YANG TERJADI AKIBAT ADANYA
    SUATU STIMULUS KUAT (MEKANIK,
    TERMAL ATAU KIMIAWI) PADA
    JARINGAN YANG INTACT (UTUH).
    • JADI ADA POTENTIAL TISSUE
    DAMAGE YANG MENGHASILKAN
    WITHDRAWAL REFLEX.
    • BELUM ADA KERUSAKAN
    JARINGAN.
    • GUNAYA SEBAGAI ALAT
    PROTEKSI TUBUH DARI BERBAGAI
    KERUSAKAN.
    Nociceptive pain
    Minimal tissue damage
    Sebenarnya pembedahan dimulai dgn nyeri nosiseptif  nyeri akut nyeri i
     sembuh nyeri hilang, kalau sembuh tapi nyerinya menetap  nyeri kronik
    Mekanisme Nyeri Nosiseptif atau Nyeri Akut
    Diantara simulus noksius dan persepsi ada 5 proses yg Persepsio
    tersendiri yaitu;  Nosisepsi (respons saraf terhadap stimulus noksius) n
    1. Transduksi
    2. Konduksi Neuron III
    3. Modulasi
    4. Transmisi
    5. Persepsi

    Transduction

    Mechanical
    Conduction
    Transmissio
    Action potential n
    Modulation
    Neuron II
    Thermal

    Neuron I
    Transmission
    Chemical

    Modified by AHT
    CHRONIC PAIN IS DESEASE
    CHRONIC PAIN
    CHRONIC PAIN IS A PAIN THAT PERSISTS
    BEYOND NORMAL TISSUE HEALING TIME,
    WHICH IS ASSUMED TO BE THREE – SIX
    MONTHS.

    The International Association for study of pain (IASP)


    (IAS

     Pain that continues when it should not.


    • POST-TRAUMATIC PAIN
    • POST-OPERATIVE PAIN
    • LABOUR PAIN

    PAIN MANAGEMENT • NERVE ENTRAPMENT SYNDROME

    • CERVICOGENIC HEADACHE
    • MSK PAIN
    RVENTIONAL PAIN MANAGEMENT • ACUTE LOW BACK PAIN & NECK PAIN WITH
    RADICULOPATHY

    • COMPLEX REGIONAL PAIN SYNDROME ( RSD)


    • HERPETIC & POST-HERPETIC NEURALGIA
    • ACUTE PANCREATITIS
    • ACUTE MYOCARDIAL INFARCTION
    • SIMPATIS BLOCK
    1. DISC PROCEDURES: DISCOGRAPHY, OZONE
    NUCLEOLYSIS, PERCUT. DISCECTOMY

    2. PERCUT. VERTEBROPLASTY
    3. SPINAL CORD STIMULATION
    4. SPINAL ENDOSCOPY
    Every thing I do is to help you
    avoid surgery”
    OUR WELL BEING, IS ONLY FREEDOM FROM PAIN” ( DE
    MONTAIGNE.1592)
    ERDOSSI 2002
    25 % HOSPITAL VISIT • PAIN CLINIC RSU KERTHA USADA
    PAIN MANAGEMENT
    CHRONIC PAIN (POST HERPES NEURALGIA)
    ACUTE PAIN (FR CRURIS )
    COIN ON THE SAND
    AS A SNIPER NOT A BOMBER
    LOST IN SPACE
    MUSCULOSKELATAL
    NERVE ENTRAPMENT
    SPINE PROBLEM
    CHEPALGIA
    CANCER PAIN
    MUSCULOSKELETAL
    INJECTION
    RADIO FREQUENCY ABLATION
    NERVE ENTRAPMENT SYNDROME
    NERVE NAME
    • GREAT OCCIPITAL NERVE • CERVICO GENIC CHEPALGIA
    • SUPRASCAPULAR NERVE • SUPRASCAPULAR NERVE ENTRAPMENT
    • PUDENDAL NERVE • PUDENDAL NERVE ENTRAPMENT
    • ABDOMINAL CUTANEUS NERVE • ABDOMINAL NERVE ENTRAPMENT SYNDROME
    • SCIATIC NERVE • PIRIFORMIS SYNDROME

    • LATERAL FEMORAL CUTANEUS • MERALGIA PARAESTHICA


    • CARPAL TUNNEL SYNDROME
    • MEDIAN NERVE
    • GUYON CANNAL SYNDROME
    • ULNAR NERVE
    • ILIOHYPOGASTRIC NERVE ENTRAPMENT
    • ILIOHYPOGASTRIC NERVE
    • OBTURATOR NERVE ENTERAPMENT
    • OBTURATOR NERVE
    • TIBIAL NERVE ENTRAPMENT SYNDROME
    • TIBIAL NERVE
    OCCIPITAL CHEPALGIA
    BLOCK GREAT OCCIPITAL

    Windt et al, 2008


    PIRIFORMIS SYNDROME
    SPINE PROBLEM

    BACK PAIN

    • DISCOGENIC PAIN
    • FACET JOINT
    • SI JOINT
    • HNP
    LUMBAL FACET
    USG
    ATIPICAL FACIAL PAIN
    TRIGEMINAL NEURALGIA
    LUMBAL FACET
    USG
    STEVE JOBS 1955
    1955--2011
    COMMON SYMPATHETIC BLOCKS

    • SPHENOPALATINE GANGLION
    • STELLATE GANGLION
    • THORACIC SYMPATHETIC CHAIN
    • CELIAC PLEXUS
    • LUMBAR SYMPATHETIC
    • SUPERIOR HYPOGASTRIC PLEXUS
    • GANGLION OF IMPAR
    SUMMARY

    • ACUTE PAIN IS A GOOD NEWS


    • CHRONIC PAIN IS A DESEASE
    • AS A SNIPER,NOT AS A BOMBER
    • DON
    DON’’T TREAT THE PICTURE

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